Computational Fluid Dynamics (CFD) and Finite Element Analysis (FEM) of a Customized Stent-Graft for Endovascular (EVAR) Treatment of Abdominal Aortic Aneurism (AAA)

Background: The treatment of abdominal aortic aneurysm (AAA) is today commonly treated by inserting a stent-graft by the endovascular route, without resorting to open surgery. However, some clinical cases do not allow this less invasive approach, meaning that the stent-graft cannot be inserted and open surgery is used. Methods: In the study, we propose a fluid-structure interaction (FSI) analysis of an aneurysmatic aorta that could not be treated with Endovascular Aneurysm Repair (EVAR). The vessel is reconstructed through segmentation from CT scans and subsequently modeled on CAD software to create the surface and thickness of the vessel itself. Subsequently, we proceeded to carry out Computational Fluid Dynamics (CFD) and FSI simulation. We propose a computational study on a vessel geometry that is faithful to reality and customized. Results: Hemodynamic variable results of the carried out simulations indicate that low velocity and consequently very low WSS areas located in aneurysmal site are no longer found when conventional or patient-specific grafts are inserted. The wall stress distribution of aorta FEM analysis enabled the identification of the area at risk of failure, that is, in the posterior part of the aneurysm (similar to 10(7) Pa), while FSI analysis of the patient-specific graft led to a uniform von Mises stresses distribution (similar to 10(5) Pa), except for the junctions where peak stress occurred. Conclusion: The importance of this study is to highlight the benefits of the personalized stent/graft. As the authors expected, the study shows the numerous benefits of the customized stent/graft in terms of blood flow trend and wall stress compared to a traditional stent/graft by supporting the tendency to want to shift the target towards customized stents/grafts, also in the vascular surgery sector.